Organization
LIFE CRAFTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MADISON LEIGH WALLACE LPCC (CEO)
(859) 630-7760
Entity
Organization
Contact information
Practice address
535 W SECOND ST STE L110, LEXINGTON, KY 40508-9002
(859) 630-7760
Mailing address
369 W VINE ST APT 1906, LEXINGTON, KY 40507-1697
(859) 630-7760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/17/2020
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